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Experts predict that more than 10,000 lives have been saved in the US since 2014 thanks to lung cancer screening.
The study, published in the BMJ, found that the introduction of lung cancer screening in December 2013 increased early detection of non-small cell lung cancer (NSCLC) by 3.9% per year and improved all cause survival by 11.9% per year between 2014 and 2018.
However, these benefits did not appear to extend to patients living in economically deprived areas or to racial or ethnic minority groups.
The authors of the study are therefore calling for increased access to screening in the US to “prevent widening disparities in the stage of lung cancer diagnosed and the survival among different patient populations with lung cancer.”
Earlier diagnoses and all cause survival rates increased
The team of researchers analysed data from two large cancer registries and identified 763,474 patients aged 45-80 years diagnosed with NSCLC between 1 January 2010 and 31 December 2018.
They then used this data to estimate annual changes in the percentage of NSCLC diagnosed at stage I among patients aged 45-54 (ineligible for screening) and 55-80 (potentially eligible for screening) alongside changes in median all cause survival, and trends in cases of NSCLC diagnosed by stage from 2010 to 2018.
While the percentage of stage I NSCLC diagnosed among patients aged 55-80 did not significantly increase from 2010 to 2013, it increased significantly by 3.9% from 2014 to 2018.
Similarly, the median all cause survival of patients aged 55-80 did not significantly increase from 2010 to 2013, but it then tripled to 11.9% per year from 2014 to 2018, resulting in an estimated 10,100 averted deaths.
Increasing screening rates could help to reduce health disparities
The study is observational, so cannot establish a cause. The researchers also point to several limitations including a lack of information on patients’ smoking history, and the possibility that their results could be explained by factors other than the introduction of lung cancer screening.
However, the authors did perform several analyses to exclude the possibility that other reasons could explain their findings (including considering increases in the overdiagnosis of lung cancer, improvements in the accuracy of clinical staging information over time, increases in the use of non-screening related diagnostic imaging, and the implementation of major provisions of the Affordable Care Act). They found that none of these factors could explain the accelerated shift towards earlier stages of the disease identified.
Lung cancer screening has been slow and screening rates have remained extremely low nationally. They say their findings therefore “indicate the beneficial effect that even a small amount of screening can have on lung cancer stage shifts and survival at the population level.”
They say efforts should therefore be made to increase screening rates across the country, ensuring more equitable access to reduce health disparities.